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Evaluation of intraocular pressure in the immediate postoperative period after phacoemulsification.
J Cataract Refract Surg. 2007 Nov; 33(11):1953-7.JC

Abstract

PURPOSE

To determine the incidence of hypotony and intraocular pressure (IOP) elevation in the immediate and early postoperative period after temporal posterior limbal phacoemulsification and intraocular lens (IOL) implantation.

SETTING

Ambulatory surgical center.

METHODS

This prospective analysis comprised 310 eyes that had temporal posterior limbal phacoemulsification with IOL implantation. Surgical parameters included keratome incision of 2.85 mm, incision length of 2.5 mm, peribulbar anesthesia, case-completion IOP of 20 mm Hg, and postoperative lid taping. The IOP measurements were collected preoperatively and 30 minutes and 1 day after surgery.

RESULTS

Nineteen eyes (6.1%) had an IOP lower than 5 mm Hg 30 minutes postoperatively in the absence of incision leakage at the paracentesis or keratome sites. Eighteen of the 19 eyes with postoperative hypotony received hydroxypropyl methylcellulose 2% (OcuCoat) and 1 received hypromellose 2% (Cellugel). None of the 23 eyes with an acrylic IOL implanted via a cylindrical lens inserter had an IOP lower than 5 mm Hg postoperatively. Suturing did not significantly affect the incidence of hypotony, and there were no postoperative complications related to hypotony. The mean IOP at 30 minutes was lower than at 1 day in the normal, glaucoma, and glaucoma-suspect groups. Twenty-one normal eyes (8.1%), 5 glaucoma eyes (15.6%), and 1 glaucoma-suspect eye (5%) had an IOP greater than 30 mm Hg 1 day postoperatively.

CONCLUSIONS

Postoperative hypotony (IOP <5 mm Hg) occurred in 19 (6.1%) of 310 eyes. At 1 day, IOP higher than 30 mm Hg was more frequent in glaucoma eyes than in normal eyes. Although there were no direct problems related to hypotony at 30 minutes or to elevated IOP (>30 mm Hg) at 1 day, surgeons should be aware of and check for IOP variability (low and high) that can occur in normal, glaucoma, and glaucoma-suspect eyes within the first 24 hours after surgery.

Authors+Show Affiliations

Ophthalmic Consultants of Boston, 50 Staniford Street, Suite 600, Boston, Massachusetts 02114, USA. bjshingleton@eyeboston.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17964404

Citation

Shingleton, Bradford J., et al. "Evaluation of Intraocular Pressure in the Immediate Postoperative Period After Phacoemulsification." Journal of Cataract and Refractive Surgery, vol. 33, no. 11, 2007, pp. 1953-7.
Shingleton BJ, Rosenberg RB, Teixeira R, et al. Evaluation of intraocular pressure in the immediate postoperative period after phacoemulsification. J Cataract Refract Surg. 2007;33(11):1953-7.
Shingleton, B. J., Rosenberg, R. B., Teixeira, R., & O'Donoghue, M. W. (2007). Evaluation of intraocular pressure in the immediate postoperative period after phacoemulsification. Journal of Cataract and Refractive Surgery, 33(11), 1953-7.
Shingleton BJ, et al. Evaluation of Intraocular Pressure in the Immediate Postoperative Period After Phacoemulsification. J Cataract Refract Surg. 2007;33(11):1953-7. PubMed PMID: 17964404.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of intraocular pressure in the immediate postoperative period after phacoemulsification. AU - Shingleton,Bradford J, AU - Rosenberg,Rhonda B, AU - Teixeira,Roberta, AU - O'Donoghue,Mark W, PY - 2006/11/21/received PY - 2007/06/11/accepted PY - 2007/10/30/pubmed PY - 2007/12/21/medline PY - 2007/10/30/entrez SP - 1953 EP - 7 JF - Journal of cataract and refractive surgery JO - J Cataract Refract Surg VL - 33 IS - 11 N2 - PURPOSE: To determine the incidence of hypotony and intraocular pressure (IOP) elevation in the immediate and early postoperative period after temporal posterior limbal phacoemulsification and intraocular lens (IOL) implantation. SETTING: Ambulatory surgical center. METHODS: This prospective analysis comprised 310 eyes that had temporal posterior limbal phacoemulsification with IOL implantation. Surgical parameters included keratome incision of 2.85 mm, incision length of 2.5 mm, peribulbar anesthesia, case-completion IOP of 20 mm Hg, and postoperative lid taping. The IOP measurements were collected preoperatively and 30 minutes and 1 day after surgery. RESULTS: Nineteen eyes (6.1%) had an IOP lower than 5 mm Hg 30 minutes postoperatively in the absence of incision leakage at the paracentesis or keratome sites. Eighteen of the 19 eyes with postoperative hypotony received hydroxypropyl methylcellulose 2% (OcuCoat) and 1 received hypromellose 2% (Cellugel). None of the 23 eyes with an acrylic IOL implanted via a cylindrical lens inserter had an IOP lower than 5 mm Hg postoperatively. Suturing did not significantly affect the incidence of hypotony, and there were no postoperative complications related to hypotony. The mean IOP at 30 minutes was lower than at 1 day in the normal, glaucoma, and glaucoma-suspect groups. Twenty-one normal eyes (8.1%), 5 glaucoma eyes (15.6%), and 1 glaucoma-suspect eye (5%) had an IOP greater than 30 mm Hg 1 day postoperatively. CONCLUSIONS: Postoperative hypotony (IOP <5 mm Hg) occurred in 19 (6.1%) of 310 eyes. At 1 day, IOP higher than 30 mm Hg was more frequent in glaucoma eyes than in normal eyes. Although there were no direct problems related to hypotony at 30 minutes or to elevated IOP (>30 mm Hg) at 1 day, surgeons should be aware of and check for IOP variability (low and high) that can occur in normal, glaucoma, and glaucoma-suspect eyes within the first 24 hours after surgery. SN - 0886-3350 UR - https://www.unboundmedicine.com/medline/citation/17964404/Evaluation_of_intraocular_pressure_in_the_immediate_postoperative_period_after_phacoemulsification_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0886-3350(07)01322-3 DB - PRIME DP - Unbound Medicine ER -